European Journal of Cancer 66 (2016) 153e16Available online at ScienceDirectjournal homepage:

Original Research

Central obesity increases risk of breast cancer irrespective of menopausal and hormonal receptor status in women of South Asian Ethnicity

R. Nagrani a, S. Mhatre a, P. Rajaraman b, I. Soerjomataram c, P. Boffetta d, S. Gupta e, V. Parmar f, R. Badwe f, R. Dikshit a,*

a Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, 400 012, India
b Center for Global Health, U.S. National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA c Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon CEDEX, France
d Institute For Translational Epidemiology, Mount Sinai Hospital, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA e Advanced Centre for Treatment, Research and Education in Cancer, Navi Mumbai, Maharashtra 400 012, India
f Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra 400 012, India

Received 7 July 2016; accepted 21 July 2016

Abstract Background: Current evidence suggests that the relationship between obesity and breast cancer (BC) risk may vary between ethnic groups.
Methods: A total of 1633 BC cases and 1504 controls were enrolled in hospital-based case econtrol study in Mumbai, India, from 2009 to 2013. Along with detailed questionnaire, we collected anthropometric measurements on all participants. We used unconditional logistic regression models to estimate odds ratios (ORs) and 95% confidence interval (CI) for BC risk associated with anthropometry measurements, stratified on tumour subtype and menopausal status.

Results: Waist-to-hip ratio (WHR) of !0.95 was strongly associated with risk of BC compared to WHR 0.84 in both premenopausal (OR Z 4.3; 95% CI: 2.9e6.3) and postmen- opausal women (OR Z 3.4; 95% CI: 2.4e4.8) after adjustment for body mass index (BMI). Premenopausal women with a BMI !30 were at lower risk compared to women with normal BMI (OR Z 0.5; 95% CI: 0.4e0.8). A similar protective effect was observed in women who were postmenopausal for <10 years (OR Z 0.6; 95% CI: 0.4e0.9) but not in women who were postmenopausal for !10 years (OR Z 1.8; 95% CI: 1.1e3.3). Overweight and obese women (BMI: 25e29.9 and ! 30 kg/m2, respectively) were at increased BC risk irrespective of

* Corresponding author: Centre for Cancer Epidemiology, Tata Memorial Centre, E. Borges Road, Parel Mumbai, Maharashtra 400 012, India. E-mail address: (R. Dikshit).   for full text 
0959-8049/a 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license ( licenses/by/4.0/).


Breast cancer; Central obesity; Menopausal status; Hormone receptor status;